Organization Active NPI

Rutowski of East Aurora Inc

  • Compounding Pharmacy
  • East Aurora, NY
National Provider Identifier
1952347403
Registry record updated Oct 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Compounding PharmacyTaxonomy code 3336C0004X
License
008425 Issued in NY
Legal business name
RUTOWSKI OF EAST AURORA INC
Practice address
597 Oakwood Ave
East Aurora, NY 14052-2333
Phone
(716) 652-1360
Fax
(716) 655-0132
NPI assigned
Jun 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. John Francis Rutowski, R.PH.
Title
Pres
Phone
(716) 652-1360

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Compounding Pharmacy 3336C0004X 008425 NY Primary
Prosthetic/Orthotic Supplier 335E00000X

Addresses

Primary practice location

597 Oakwood Ave
East Aurora, NY 14052-2333

Mailing address

597 Oakwood
East Aurora, NY 14052
Phone (716) 652-1360

Other identifiers 3

IdentifierTypeStateIssuer
00607992MedicaidNY
1952347403MedicaidNY
2057148OtherPK

Other names 1

  • Larwood Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20220110001554 NY DME Supplier - Pharmacy 7517359268 Practice locations: East Aurora, NY
O20220208000972 NY Part B Supplier - Mass Immunization (Roster Biller Only) 7517359268 Practice locations: East Aurora, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Rutowski of East Aurora Inc597 Oakwood Ave, East Aurora, NY 14052-2333(716) 652-1360 Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Heat & Cold Applications|Support Surfaces: Pressure Reducing Beds/Mats/Pads|(TENS) Transcutaneous Electrical Nerve Stimulators and/or Supplies|Canes and/or Crutches|Patient Lifts|Seat Lift Mechanisms|Walkers|Wheelchairs (St… Does not accept assignmentParticipating since Dec 5, 2021

National Provider Directory

National Provider Directory

Locations

597 Oakwood Ave
East Aurora, NY 14052
Phone (716) 652-1360

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634688000000",
    "number": "1952347403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "597 OAKWOOD",
            "city": "EAST AURORA",
            "state": "NY",
            "postal_code": "14052",
            "telephone_number": "716-652-1360",
            "fax_number": "716-655-0132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "597 OAKWOOD AVE",
            "city": "EAST AURORA",
            "state": "NY",
            "postal_code": "140522333",
            "telephone_number": "716-652-1360",
            "fax_number": "716-655-0132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUTOWSKI OF EAST AURORA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-22",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A",
        "authorized_official_last_name": "RUTOWSKI",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "FRANCIS",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "716-652-1360",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NY",
            "license": "008425",
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00607992",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1952347403",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2057148",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Larwood Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in East Aurora, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.